Amy Thommasen1, Fiona Clement2, David W Kinniburgh3, Cheryl K Lau4, Maggie Guo4, Jeannine Viczko4, Kelly Guggisberg1, Roger E Thomas5, Tanvir Chowdhury Turin5, James C Wesenberg6, Amid Abdullah1, William S Hnydyk7, Christopher Naugler8. 1. Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, 3535 Research Rd NW, Calgary, Alberta T2L 2K8, Canada. 2. Department of Community Health Sciences, Faculty of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada. 3. Alberta Centre for Toxicology, University of Calgary, HM B19, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada. 4. Alberta Health Services Provincial Lab Utilization Office, 3535 Research Rd NW, Calgary, Alberta T2L 2K8, Canada. 5. Department of Family Medicine, Cumming School of Medicine, University of Calgary, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada. 6. Red Deer Regional Hospital Centre, Clinical Laboratory, 3942 50A Avenue, Red Deer, Alberta T4N 4E7, Canada. 7. Alberta Medical Association, 12230 106 Ave NW, Edmonton, Alberta, T5N 3Z1, Canada. 8. Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, 3535 Research Rd NW, Calgary, Alberta T2L 2K8, Canada; Department of Family Medicine, Cumming School of Medicine, University of Calgary, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada. Electronic address: Christopher.Naugler@cls.ab.ca.
Abstract
OBJECTIVES: Mitigation of unnecessary and redundant laboratory testing is an important quality assurance priority for laboratories and represents an opportunity for cost savings in the health care system. Family physicians represent the largest utilizers of laboratory testing by a large margin. Engagement of family physicians is therefore key to any laboratory utilization management initiatives. Despite this, family physicians have been largely excluded from the planning and implementation of such initiatives. Our purposes were to (1) assess the importance of lab management issues to family physicians, and (2) attempt to define the types of initiatives most acceptable to family physicians. DESIGN AND METHODS: We invited all Alberta family practice residents and practicing physicians to participate in a self-administered online electronic survey. Survey questions addressed the perceived importance of lab misutilization, prevalence of various types of misutilization, acceptability of specific approaches to quality control, and responsibility of various parties to address this issue. RESULTS: Of 162 respondents, 95% considered lab misutilization to be either important or very important. Many physicians placed the responsibility for addressing lab misutilization issues on multiple parties, including patients, but most commonly the ordering physician (97%). Acceptability for common strategies for quality improvement in lab misutilization showed a wide range (35%-98%). CONCLUSIONS: These responses could serve as a framework for laboratories to begin discussions on this important topic with primary care groups.
OBJECTIVES: Mitigation of unnecessary and redundant laboratory testing is an important quality assurance priority for laboratories and represents an opportunity for cost savings in the health care system. Family physicians represent the largest utilizers of laboratory testing by a large margin. Engagement of family physicians is therefore key to any laboratory utilization management initiatives. Despite this, family physicians have been largely excluded from the planning and implementation of such initiatives. Our purposes were to (1) assess the importance of lab management issues to family physicians, and (2) attempt to define the types of initiatives most acceptable to family physicians. DESIGN AND METHODS: We invited all Alberta family practice residents and practicing physicians to participate in a self-administered online electronic survey. Survey questions addressed the perceived importance of lab misutilization, prevalence of various types of misutilization, acceptability of specific approaches to quality control, and responsibility of various parties to address this issue. RESULTS: Of 162 respondents, 95% considered lab misutilization to be either important or very important. Many physicians placed the responsibility for addressing lab misutilization issues on multiple parties, including patients, but most commonly the ordering physician (97%). Acceptability for common strategies for quality improvement in lab misutilization showed a wide range (35%-98%). CONCLUSIONS: These responses could serve as a framework for laboratories to begin discussions on this important topic with primary care groups.
Authors: Christopher Naugler; Brenda Hemmelgarn; Hude Quan; Fiona Clement; Tolulope Sajobi; Roger Thomas; Tanvir C Turin; William Hnydyk; Alex Chin; James Wesenberg Journal: CMAJ Open Date: 2017-01-17